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ESSENTIAL V OF THE ESSENTIALS OF DOCTORAL EDUCATION FOR ADVANCED NURSING PRACTICE DESCRIBES THE ROLE OF THE DNP IN HEALTHCARE POLICY AS AN ADVOCATE FOR PATIENTS. DISCUSS HEALTHCARE POLICY AS IT RELATES TO BEHAVIORAL HEALTH MANAGEMENT FOR PATIENTS AND THE ROLE OF THE DNP
A

Essential V of the Essentials of Doctoral Education for Advanced Nursing Practice describes the role of the DNP in healthcare policy as an advocate for patients. Discuss healthcare policy as it relates to behavioral health management for patients and the role of the DNP

/Module V: Behavioral Health

Introduction

Challenges posed in providing care to patients with behavioral health issues are not unfamiliar to most health professionals. Patients with behavioral health issues are complex and require an array of services that can only be effectively delivered through a collaborative approach. Many collaborative models can be integrated into the planning process for delivery of care. Behavioral health issues, like chronic disease, require ongoing evaluation and timeliness of treatment for outcomes management. Chapter 10 provides an overview of the challenges in delivering these services. The focus will be on the following question: How is it possible, with the integration of collaboration, to have quality outcomes for both patients and providers?

Objectives

Upon completion of Module V, students will be able to:

state one barrier to providing behavior health services in primary care settings.
discuss the complexities of behavioral health management.
explain documentation and development of treatment plans utilizing DSM-IV.
determine an effective collaborative model to meet the needs of patients in their clinical setting.
Readings

Freshman, Rubino, &Chassiakos, Chapter 10
The Benefits of Interprofessional Care for Chronic Disease Management

Management of behavioral health is as challenging as chronic disease management. Many behavioral health issues coexist with other chronic disease states in patients. Successful chronic disease management is augmented by interprofessional collaboration. By 2020, chronic diseases such as hypertension, DM, arthritis, chronic obstructive pulmonary disease, and coronary artery disease will be the main causes of death and disability in the United States. These figures are astounding, and healthcare providers have a responsibility for curtailing costs by utilizing evidenced-based practice methods for the delivery of comprehensive medical care. Chronic care measures improve when aggressive healthcare teams form partnerships with informed patients to provide healthcare that improves quality. Patients with chronic disease are burdened with the lifetime commitment of care management, which includes addressing the need for ongoing learning in partnership with the healthcare provider and interdisciplinary team.

Behavioral Health

“Mental disorders are common in the United States and internationally. An estimated 26.2 % of Americans ages 18 and older—about one in four adults—suffer from a diagnosable mental disorder in a given year. When applied to the 2014 U.S. Census residential population estimate for ages 18 and older, this figure translates to 61 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion—about 6 percent, or 1 in 17—that suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada. Many people suffer from more than one mental disorder at a given time. Nearly half (45 %) of those with any mental disorder meet criteria for two or more disorders, with severity strongly related to comorbidity” (National Institute of Mental Health, 2010).

Behavioral health encompasses care of mental health conditions guiding adults and children to maintain healthy lifestyle and quality outcomes. Behavioral health issues are complex and challenging for both patients and providers, therefore quality outcomes are improved with pooled resources. Behavioral health impacts the social, physical, psychological, economical, and spiritual well-being of individuals. The Diagnostic and Statistical Manual of Mental Disorders Revision V (DSM V) of the American Psychiatry Association lends guidance for development of comprehensive care.

Incentives from private insurers, medical assistance, and Medicare have been less than inviting for primary care providers who administer care for patients with alterations in behavioral health. Therefore, coordination of care with mental health providers is lacking, due to this disconnect in care.

Collaborative care is instrumental in guiding the process that promotes success with patients having mental disorders. These patients usually access care through primary care providers who are not always knowledgeable of the presentation of mental health disorders. Furthermore, assessment of these conditions is a challenge. Patients require ongoing, evaluative treatment to prevent relapses. Collaboration with mental health providers and behavioral specialists can prevent these relapses that often can lead to suicide and decreased compliance with medications.

It is logical to conclude that healthcare services required by patients with mental health illness differ from care routinely required by patients who access primary care providers. Use of the DSM-V for mental health management propels the schematic of service for these patients. Outcomes for behavioral health differ from the physiologic parameters of other chronic diagnoses such as diabetes. The evaluative areas need to be itemized so members of collaborative teams can effectively communicate the coordination of care.

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